Health Secretary Humza Yousaf has announced a new £10 million Long COVID Support Fund to help health boards respond to the condition.
The announcement follows Mr Yousaf meeting with a range of healthcare professionals at Eastwood Health and Care Centre in East Renfrewshire and speaking with patient Pamela Bell who has been receiving support for long COVID since she contracted the virus almost a year ago.
The Long COVID Support Fund is designed to maximise and improve the co-ordination of a broad range of existing services across the health and social care system and Third Sector in response to the condition. It will be a flexible fund that will be tailored to local needs. It will strengthen the range of information and advice available, and ensure the right support is available within primary care, providing a response focused on each patient’s needs, with referrals to secondary care where necessary.
Mr Yousaf said:
“We know that long COVID can’t be handled with a one-size-fits-all approach. It can be complex and involve an array of diverse symptoms and combinations of those symptoms.
“The new Long COVID Support Fund will give our NHS Boards the flexibility to design and deliver the best care for those with long COVID, tailored to the specific needs of their populations.
“It’s been great to meet Pamela and hear how she has benefited from care and rehabilitation in a setting close to home. Long COVID patients are being supported by the full range of NHS services – primary care teams and community-based rehabilitation services with referrals to secondary care where necessary – and I want to thank our dedicated staff for their hard work.”
Mrs Bell, 62, from Glasgow, met with the Health Secretary to discuss her experience since testing positive for COVID last September. She has a mild chest condition – bronchiectasis – which meant she had to shield at the start of the pandemic. After contracting the virus she was admitted to hospital where she ended up in intensive care and intubated for almost three months.
By the time she was transferred to a respiratory ward on Hogmanay, she could not move and ultimately went to a Physical Disability Rehabilitation Unit for intensive physiotherapy and Occupational Therapy.
She also received intervention and oxygen therapy in a respiratory ward, and returned home with long-term oxygen at the beginning of June, where she receives ongoing care from a Community Rehabilitation Team to support her to regain her independence, function and mobility. Mrs Bell, who previously worked in a children’s nursery, has had to retire due to ill health.
Mrs Bell, a mother-of-two who is due to become a grandmother next Spring, said:
“Recently I was able to walk for two minutes and 40 seconds – which is a huge achievement for me.
“Before COVID, I was a senior child development officer, which involved outdoor play. I’d be in the playground or taking the children on forest walks, doing at least 15,000 steps a day. I’d help out in my community. I was there for everybody.
“This last year has been a challenge, when I’ve had to let other people take care of me. But I’m blown away by everything I’ve been given by the NHS. They are just amazing. Some of them visit me weekly, some are at the end of the phone, they deliver my oxygen and really look after me.”
Details of the new Long COVID Support Fund will be shared with NHS Boards in due course.
Scotland’s largest ever vaccination programme will complete second doses for all over 18s who have attended their scheduled appointments by close of play on Sunday 12 September.
Some of those eligible have rearranged their appointment for health or work reasons and will get their second dose shortly. Vaccination Clinics will remain open and anyone who has not yet received their vaccination, for whatever reason is reminded that it is never too late to get vaccinated and is urged to go to a local drop-in clinic or go to NHS Inform to book a convenient appointment.
The second dose of the vaccine offers greater and longer lasting protection and can be given from eight weeks after the first, either at a drop-in clinic or by requesting an appointment through the NHS Inform website.
Evidence shows that after two doses the vaccines are more than 90% effective against hospital admissions from the effects of the virus.
Students from the UK and abroad are included in the national programme and are encouraged to come forward for vaccination regardless of whether they require their first, second or both doses.
Health Secretary Humza Yousaf said: “Today is a significant day because every single adult in Scotland has now been given the opportunity to be fully vaccinated against COVID-19.
“I want to pass on my thanks to all those who have helped make this possible – from the scientists who developed the vaccine, to the hard-working staff delivering the programme on the ground. I also want to thank everyone who has taken up their offer of a vaccine, and rolled up their sleeves to help tackle coronavirus.
“To all those who haven’t yet had their second doses, please don’t leave the job half done. Even if the time since the first dose is more than eight weeks, people can still be vaccinated and I encourage them to come forward.
“We have made getting a vaccination easier than ever – head to one of the drop-in clinics being offered across the country or, if you prefer, book an appointment online at NHS Inform. Please check your NHS board’s social media posts for the latest information on where you can attend.
“Students heading to university or college from anywhere in the UK or abroad are reminded they too are urged to take up this offer if it’s relevant to them – indeed, in addition to drop-in clinics around the country, mobile vaccination units are visiting several further education campuses.
“Recent increases in case numbers mean it remains crucial everyone who is offered a vaccination takes up the invitation.”
The latest Emergency Department performance figures for August 2021 show the worst four-hour performance since records began, the worst performance for an August, and the fourth highest number of 12-hour stays ever.
The data show there were 1,342,250 attendances to Type 1 Emergency Departments in England in August 2021, a decrease of 6% compared to the previous month. Despite the decrease in attendances, four-hour performance deteriorated for the fifth consecutive month while the number of 12-hour stays increased for the fourth consecutive month.
In Type 1 Emergency Departments, 66.2% of patients were seen in four-hours or less, the worst four-hour performance on record and equal to over one-third of patients staying in a Type 1 Emergency Departments for over four-hours.
2,794 patients stayed in an Emergency Department for 12-hours or more, this is a 26% increase on the previous month and is the highest ever for August, it is also the fourth highest figure on record.
Data also show there were a total of 71,894 booked appointment attendances, with 34,787 of these booked at Type 1 Emergency Departments. Four-hour performance was at its lowest since records began, with 91.6% of all attendances seen within four-hours, and 82.5% of Type 1 attendances seen withing four-hours.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “These figures come as no surprise, but they are no less appalling. The health service has been severely struggling in recent months and the College has been vocal in its warnings about this trajectory. We are now in autumn and the workforce is seriously apprehensive about this winter and what it might bring.
“The pandemic has highlighted stark inequalities; different parts of the country have been affected to different degrees of severity – and the continued impact and recovery has been harder in more deprived areas. In particular, the urgent and emergency care systems in the North East and North West are facing particularly extreme pressures.
“Average four-hour performance in the both the North East and North West is 63% while in the South East it is 73%. As part of levelling up, it is vital that these inequalities are properly addressed and not overlooked, and that support is given to those areas and to those patients that need it most.
“Departments also need clarity of focus in terms of priorities, and the priority must be long stays – this month’s fourth worst ever number of 12-hour stays shows the desperate need to improve the flow of patients through hospitals. But England continues to only publish 12-hour data measuring from decision to admit. Good statistics that accurately measure performance are essential in improving systems and publishing 12-hour data from time of arrival would show the true scale of the problem of long stays.
“The data also show that performance against booked appointments has sharply deteriorated. We must properly evaluate the efficacy of NHS 111 ‘talk first’ approach, so we can begin to improve it. There must be an adequate range of services available that NHS 111 to which call handlers are able to direct patients. Patients must be able to be directed to the right place for their care, and any patient booking an appointment at A&E through 111 must not be left waiting for a long period of time.
“At the same time there must be a renewed focus on the workforce. Our survey from July 2021 showed that half of all respondents said they were considering reducing their hours, while a large proportion are thinking of taking a career break or even changing specialty.
“The workforce cannot afford to lose any Emergency Department staff, we must do all we can to retain existing workers. To tackle this there must be a recruitment drive for Emergency Departments, in England 2,500 more consultants are needed – alongside sufficient numbers of nurses, trainees, allied health professionals and SAS doctors.
“To reduce crowding in hospitals, there must be investment in alternative care pathways including same day emergency care and discharge to assess, these will help prevent unnecessary admission.
“The vision for urgent and emergency care must be implemented and Emergency Medicine staff need to be assured that progress is being made. The College has laid out what needs to be done in RCEM CARES, and reports including; Summer to Recover; and Retain, Recruit, Recover.
“Patient safety is at risk and on this trajectory, winter will be far worse than previously forecast – it is a looming crisis – and the health service is on the brink. The cost will be huge. Funding is welcome, but a comprehensive, joined-up plan, that must include short-term actions for the winter ahead together with a long-term strategy is vital.
“We are at a crucial point; Emergency Department performance continues to deteriorate while elective care waiting lists continue to rise steeply. The government must see the iceberg ahead and steer the health and social care service to safety.”
Edinburgh’s Transport leaders have welcomed calls by more than 140 medical professionals to retain and expand upon measures introduced to support walking, wheeling and cycling during lockdown.
Doctors and health workers from across the city have published an open letter to the City of Edinburgh Council in support of the Travelling Safely programme, formerly Spaces for People.
The group cites the positive impacts of more active travel on health, inequality, air quality and in tackling the climate crisis, amongst other benefits.
In June, Transport and Environment Committee approved proposals to retain some of the schemes on an experimental basis, to remove others post-pandemic and to engage further with communities on options for a handful of measures.
Councillor Lesley Macinnes, Transport and Environment Convener said: “The collective voice of this wide range of medical and health professionals is incredibly welcome.
“We’ve been vocal about our commitment to encourage travel by foot, wheel or bike, and the benefits this brings, but to have the support of the medical profession demonstrates just how crucial investment in safe, protected routes is.
“Over the last year and a half we’ve introduced changes which have helped many people to feel newly confident about walking, cycling and wheeling safely. There are, of course, tens of thousands of people in Edinburgh who don’t have access to a car. We now have the opportunity to extend the lifespan of many of these measures and to improve upon them so that they work for as many people as possible.
“The evidence is clear and well expressed in this letter – there’s so much to gain from active travel, in terms of health, quality of life and in limiting our impact on the climate. We simply cannot return to the status quo, where private car journeys dominate the streets.
“By retaining the majority of schemes introduced through Spaces for People, we’re laying the foundations for a happier, healthier future for everyone here.
Councillor Karen Doran, Transport and Environment Vice Convener, said: “It’s indisputable that walking, wheeling or cycling, whether for leisure or commuting, has a positive impact on our health, our state of mind and our pockets, as well as the air we breathe. We wholeheartedly recognise and support these calls to retain and expand on the measures we’ve introduced during the pandemic.
“Temporary protected cycle lanes, widened pavements and quiet routes have helped families to walk safely to school, shoppers to spend time strolling through some of our iconic city centre streets and people trying out cycling for the first time.
“We really want to continue delivering these benefits, and we’ll be working hard to make sure the measures we have kept do just that.”
We are a group of doctors and other health professionals, living or working in Edinburgh, and write to support the retention and extension of changes to travel infrastructure in Edinburgh and the Lothians, to improve public health and mitigate climate emergency. We hope that the points and evidence below will support the council to make decisions that will help to benefit, protect, and reduce inequalities in the health of the population of Edinburgh.
Climate crisis and health
One of the duties of a doctor as stated by the General Medical Council is “to protect and promote the health of patients and the public”1. As health professionals we have been reminded by our professional bodies of our responsibilities to raise the profile of the climate emergency, which is a public health emergency likely to have a much greater impact than COVID-192,3.
We have a responsibility to speak up for disadvantaged groups who are disproportionately vulnerable to the health and economic impacts of the climate crisis.
Health Inequality
Those living in areas of deprivation are less likely to drive but much more likely to be injured in a road traffic collision6. Rates of pedestrian casualties are twice as high in children as in adults, and pedestrians over 70 years of age have the highest fatality rate7.
Many of our patients do not have the financial means, health status, or abilities to access private car transport. Children, the frail elderly, and people with chronic illnesses or disabilities are disadvantaged in opportunities to access services and community by systems which prioritise private car transport.
Moves to promote safe active travel, including widening of pavements and provision of segregated paths, make the urban environment more accessible for people with disabilities and release road space for reliable and efficient public transport.
Measures to improve the urban environment and promote active travel in Edinburgh will differentially benefit the most disadvantaged members of our community and so help to reduce health inequalities in Edinburgh. We ask that councillors carefully consider the differential impact of decisions to prioritise private car transport on those for whom private car transport is not an option.
Air pollution and health
Air pollution is strongly associated with poor health outcomes. A joint Royal College of Physicians and Royal College of Paediatrics and Child Health report estimated that outdoor air pollution causes 40,000 deaths a year in the UK. Data from Scotland shows a particularly strong association between air pollution and respiratory disease and deaths. Transport – predominantly car transport – is the main source of air pollution in Scotland.
Edinburgh City Council has six Air Quality Management Areas, with concerning levels of air pollution related to vehicular traffic.
Decisive action from the council to promote active travel and reduce private car traffic in Edinburgh will help to reduce air pollution and associated harm to health.
Physical activity and health
Regular physical activity is associated with improved health outcomes at all ages13.
UK Chief Medical Officers recommend that children and young people should engage in moderate physical activity for at least one hour every day. For adults, 150 minutes of moderate activity per week is associated with a 40% reduction in risk of type 2 diabetes, 35% reduction in heart disease, 25% reduction in joint and back pain, and 20% reduction in bowel and breast cancer13.
National data indicates that in Scotland during 2019 only 66% of adults met this target, whilst in the same year fewer than 50% of journeys under two miles were made on foot14.
Segregated active travel infrastructure allows everyone to increase their physical activity levels through active travel; not only those who already enjoy regular physical activity.
We ask that the council considers the beneficial and protective health effects of physical activity when considering its decisions about travel infrastructure in Edinburgh.
Behaviour change for public health
Changing established patterns of behaviour is difficult. We understand that a move away from the current position of private car dependency can feel difficult.
Bold Scottish strategies have led to strikingly effective population shifts in behaviour for better health; tobacco smoking restrictions have saved many lives, and early data suggests that minimum alcohol unit pricing has reduced the amount of alcohol purchased by the heaviest alcohol consumers15,16. Both of these strategies met with initial resistance, but are now broadly supported.
Now, local government in Edinburgh has the potential to lead a bold and exemplary modal shift away from car-dependence which will benefit and protect the health of the people of Edinburgh.
Key Points
As health professionals, we have a responsibility to protect and promote the health of the population. We have a responsibility to address inequalities and to advocate for the needs of the most deprived and disadvantaged members of the population we serve.
We are concerned about the impact of the climate crisis on health, globally and locally.
We are concerned about harms to health caused by air pollution in Edinburgh.
Regular physical activity is associated with improved health outcomes at all ages.
We support the retention, and further development and integration of infrastructures designed to support active travel and clean air for the whole population of Edinburgh, to mitigate inequalities in health, local mobility, and air quality.
This includes quiet routes in the vicinity of schools to allow safe active travel for families, an integrated network of segregated safe paths for cycling, city-wide subsidised cycle hire programmes, and low-emission zones.
We are concerned that suggested steps to reverse active travel measures introduced during the COVID-19 pandemic would be a retrograde and harmful step for the health of the population of Edinburgh.
Yours sincerely,
Dr Laura McWhirter, Consultant Neuropsychiatrist, Edinburgh Neil Aitken, Physiotherapist, Neil Aitken Physiotherapy Ltd, Edinburgh Dr Niall H. Anderson, Senior Lecturer in Medical Statistics, Usher Institute, University of Edinburgh Dr Ross Archibald, Consultant in Emergency Medicine, NHS Lothian Dr Elika Aspinall, General Practitioner, NHS Lothian Dr Katherine Atkins, Chancellor’s Fellow, Edinburgh Medical School, University of Edinburgh Dr Paul Bailey, General Practitioner, NHS Lothian Miss Emily Baird, Consultant, Children’s Orthopaedics, Royal Hospital for Children and Young People Edinburgh Dr Kasia Banas, UG Talent Lead and Programme Director in Data-Driven Innovation for Health and Social Care, Usher Institute, University of Edinburgh Dr Ravneet Batra, Consultant Liaison Psychiatrist, Regional Infectious Diseases Unit, Western General Hospital Dr Roland Baumann, General Practitioner, Niddrie Medical Practice, Edinburgh Dr Craig Beattie, Consultant Anaesthetist, Royal Infirmary of Edinburgh Dr Monika Beatty, Consultant in Critical Care, Royal Infirmary of Edinburgh Dr Sam Bennett, Foundation Doctor, Acute Medicine, Western General Hospital Ms Katherine Bethell, Advanced Nurse Practitioner and Programme Manager, Chalmers Sexual Health Centre (Lothian) and Sandyford Centre (GGC) Dr David Birrell, Emergency medicine trainee, Royal infirmary of Edinburgh; Honorary Clinical Fellow, University of Edinburgh Professor James Boardman, Professor of Neonatal Medicine, University of Edinburgh Dr Friederike Boellert, Respiratory Consultant, Western General Hospital, Edinburgh Dr Kirsty Boyd, Reader in Palliative Care, Usher Institute, University of Edinburgh Dr Tom Bloomfield, Consultant Anaesthetist, Royal Infirmary of Edinburgh Mr Paul Brennan, Reader and Honorary Consultant Neurosurgeon, University of Edinburgh and NHS Lothian Mr Iain Brown, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh Dr John Budd, General Practitioner, Edinburgh Access Practice, and Co-ordinator of Lothian Deprivation Interest Group Dr Rosamunde Burns, Consultant Anaesthetist, Royal Infirmary of Edinburgh Dr Peter Cairns, General Practitioner, Wester Hailes Medical Practice Professor Alan Carson, Consultant Neuropsychiatrist, University of Edinburgh Dr Simon Chillingworth, Consultant Anaesthetist, Royal Infirmary of Edinburgh Professor Richard Chin, Professor of Paediatric Neurology and Clinical Epidemiology, Honorary Consultant Paediatric Neurologist, University of Edinburgh and The Royal Hospital for Children and Young People Dr Sarah Clay, Locum General Practitioner, Niddrie Medical Practice, and Specialty Doctor in Palliative Care Dr Elizabeth Cole, Anaesthetics registrar, Royal Infirmary of Edinburgh Dr Catherine Collinson, Consultant Anaesthetist, Department of Anaesthesia, Royal Infirmary of Edinburgh Dr Claire Cooke-Jones, Trainee Anaesthetist, Royal Infirmary of Edinburgh Dr Robert Cooke-Jones, Trainee General Practitioner, Inchpark Surgery, Edinburgh Dr Nadine Cossette, Consultant Liaison Psychiatrist, Royal Infirmary of Edinburgh Dr Helen Creedon, Clinical Fellow in Oncology, University of Edinburgh Dr Julia Critchley, Consultant Anaesthetist, Royal Infirmary of Edinburgh Dr Craig Davidson, Consultant in Emergency Medicine, NHS Lothian Professor Adrian Davis, Professor of Transport & Health, Edinburgh Napier University Dr Christopher Dickens, General Practitioner, Edinburgh Ms Lynsey Downie, Anaesthesia Associate, Edinburgh Royal Infirmary Mr Andrew Duckworth, Senior Lecturer and Consultant Orthopaedic Trauma Surgeon, Edinburgh Orthopaedics and University of Edinburgh Mr Joseph Duncumb, Orthopaedic Surgery Registrar, Royal Infirmary of Edinburgh Dr Tamasin Evans, Consultant Clinical Oncologist, Edinburgh Cancer Centre Dr Alasdair Fitzgerald, Clinical Lead, Rehabilitation Services and Consultant in Neurorehabilitation, Astley Ainslie Hospital, Edinburgh Dr Nicholas Fletcher, Trainee General Practitioner, NHS Education Scotland Professor Sue Fletcher-Watson, Chair in Developmental Psychology, Division of Psychiatry, University of Edinburgh Mr Martin Gemmell, Principal Educational Psychologist, City of Edinburgh Council Ms Paula Gardiner, Neurological Specialist Physiotherapist and Cognitive Behavioural Therapist, Edinburgh Dr Cameron J Fairfield, Clinical Research Fellow, University of Edinburgh Dr Gavin Francis, General Practitioner, Dalkeith Road Medical Practice, Edinburgh Dr Allan Gordon, Retired Consultant Obstetrician and Gynaecologist, Edinburgh Dr Claire Gordon, Consultant in Acute Medicine, Western General Hospital, Edinburgh Dr Rebecca Gormley, Anaesthetic Core Trainee, Royal Infirmary of Edinburgh Dr Peter S Hall, Honorary Consultant Medical Oncologist, Edinburgh Cancer Centre at St John’s Hospital and the Western General Hospital Dr Helen Hare, Junior Doctor, Edinburgh Royal Infirmary Dr Simon Heaney, Consultant Anaesthetist, Royal Infirmary of Edinburgh Dr Ingrid Hoeritzauer, Consultant Neurologist and Acute Traumatic Brain Injury Rehabilitation, Royal Infirmary of Edinburgh Dr Catriona Howes, Consultant Psychiatrist, Western General Hospital, Edinburgh Dr Seán Keating, Consultant in Cardiothoracic Anaesthesia and Intensive Care Medicine, Royal Infirmary of Edinburgh Dr Malik Jahangeer, Consultant Clinical Oncologist and Honorary Senior Clinical Lecturer, University of Edinburgh Dr Marc Janssens, Consultant Anaesthetist, Royal Infirmary of Edinburgh Mr Aimun Jamjoom, Speciality Neurosurgery Trainee, Edinburgh Royal Infirmary Dr Michelle Jeffrey, Consultant Sports and Exercise Medicine, Sportscotland Institute of Sport, Oriam, Edinburgh Dr Guy Johnson, General Practitioner (retired), Sighthill Health Centre Professor John Keating, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh; Honorary Senior Lecturer, Edinburgh University Dr Stephanie Kelly, Clinical Fellow in Intensive Care, Royal Infirmary of Edinburgh Dr Dean Kerslake, Consultant, Royal Infirmary of Edinburgh Dr Alice King, Trainee General Practitioner, Edinburgh Dr Oliver Koch, Consultant & Honorary Senior Clinical Lecturer in Infectious Diseases, Regional Infectious Diseases Unit, Western General Hospital Dr Rebecca Lawrence, Consultant Psychiatrist in Addictions, Royal Edinburgh Hospital Mr Graham Lawson, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh Yvonne Leavy, Lead Clinical Nurse Specialist (epilepsy) Department for Clinical Neurosciences, RHCYP, Royal Infirmary of Edinburgh Dr Katharine Logan, Consultant Psychiatrist in Psychotherapy, Rivers Centre, Edinburgh Dr Nazir Lone, Honorary Consultant and Senior Lecturer in Critical Care, Royal Infirmary of Edinburgh, NHS Lothian and University of Edinburgh Dr Carey Lunan, General Practitioner, Craigmillar Medical GroupDr Saturnino Luz, Reader in Medical Informatics, Usher Institute, Medical School, The University of Edinburgh Dr Saturnino Luz, Reader in Medical Informatics, Usher Institute, Medical School, The University of Edinburgh Dr Sonia MacCallum, General Practitioner, Niddrie Medical Practice Dr Claire Mackintosh, Consultant Infectious Disease Physician and Clinical Director, Regional Infectious Disease Unit, NHS Lothian Dr Ivan Marples, Consultant in Pain Medicine and Anaesthesia, Leith Community Treatment Centre Dr Katie Marwick, Clinical Lecturer in Psychiatry, University of Edinburgh Dr Alexander von Maydell, Junior Doctor, Royal Infirmary of Edinburgh Miss Julie McBirnie, Consultant Orthopaedic Surgeon, Spire Shawfair Park Hospital Professor Alison McCallum, Centre for Population Health Sciences, Usher Institute, University of Edinburgh Dr Dermot McKeown, Consultant Anaesthetist, Royal Infirmary of Edinburgh Professor Andrew McIntosh, Professor of Biological Psychiatry and Honorary Consultant Psychiatrist, University of Edinburgh Dr Christina McManus, Doctor, Western General Hospital Dr Carinne McMurray, General Practitioner, Craigmillar Medical Group Professor Stewart Mercer, Professor of Primary Care and Multimorbidity, Usher Institute, University of Edinburgh; General Practitioner, NHS Lothian Dr Eve Miller-Hodges, Senior Clinical Lecturer & Honorary Consultant in Inherited Metabolic Disorders and Renal Medicine, Scottish Inherited Metabolic Disorders Service & University of Edinburgh Dr Lyle Moncur, Consultant in Emergency Medicine, Royal Infirmary of Edinburgh Mr Matthew Moran, Consultant Orthopaedic Surgeon, Royal Infirmary of Edinburgh Dr Catriona Morton, General Practitioner, Craigmillar Medical Group Dr Megan Mowbray, Consultant Dermatologist, Clinical Lead Dermatology, Skin Cancer Lead NHS Fife, Queen Margaret Hospital, Dunfermline (& resident of Edinburgh) Mr Samuel Molyneux, Consultant in Trauma and Orthopaedic Surgery, Royal Infirmary of Edinburgh Ms Mome Mukherjee, Senior Research Fellow, Usher Institute, University of Edinburgh Dr Nóra Murray-Cavanagh, Clinical Lead General Practitioner, Wester Hailes Medical Practice Dr Susan Nelson, General Practitioner, Mackenzie Medical Centre, Edinburgh Dr Anna Noble, General Practitioner, Wester Hailes Medical Practice David Obree, Archie Duncan Fellow in Medical Ethics and Fellow in Medical Education, Usher Institute, University of Edinburgh Dr Richard O’Brien, Consultant Stroke Physician, Royal Infirmary of Edinburgh, Honorary Clinical Senior Lecturer, University of Edinburgh Dr Laura O’Conaire, General Practitioner, Braefoot Medical Practice, Edinburgh Dr Rory O’Conaire, General Practitioner, West End Medical Practice, Edinburgh Dr Ailis Orr, Consultant Paediatrician, Royal Hospital for Children and Young People, Edinburgh Mr James Patton, Clinical Director Orthopaedics, Consultant Orthopaedic Surgeon, Royal Infirmary Edinburgh Dr. Meghan Perry, Consultant Physician and Honorary Senior Clinical Lecturer in Infectious Diseases and General Internal Medicine, Western General Hospital, Edinburgh Dr Sharon Peoples, Consultant in Clinical Oncology, Edinburgh Cancer Centre Professor Martyn Pickersgill, Co-Director of Research, Usher Institute, University of Edinburgh Dr Evgeniya Plotnikova, Teaching Fellow, Master of Public Health Programme, University of Edinburgh Dr S.G. Potts, Consultant in Transplant Psychiatry, Royal Infirmary of Edinburgh Dr Michael Quinn, General Practitioner, Craigmillar Medical Group Dr Martin Quirke, Research Fellow, Centre for Environment, Dementia and Ageing Research, University of Stirling (& resident of Edinburgh) Dr Kristiina Rannikmäe, Consultant Neurologist and Clinical Research Fellow, Forth Valley Royal Hospital and University of Edinburgh Ms Aїcha Reid, Registered Educational Psychologist, Edinburgh Dr Helga Rhein, General Practitioner (retired), Edinburgh Dr Helen Riches, General Practitioner, Restalrig Park Medical Centre, Edinburgh Professor Craig Ritchie, Professor of Psychiatry of Ageing, University of Edinburgh; Director of Brain Health Scotland Dr Alasdair Ruthven, Consultant Anaesthetist, Royal Infirmary of Edinburgh Professor Rustam Al-Shahi Salman, Professor of Clinical Neurology at the University of Edinburgh; Honorary consultant neurologist in NHS Lothian Dr Euan Sandilands, Consultant Toxicologist and Director National Poisons Information Service (Edinburgh); Honorary Clinical Senior Lecturer, University of Edinburgh Ms Chloe Scott, Consultant Trauma and Orthopaedic Surgeon, Royal Infirmary of Edinburgh Dr Ann Sergeant, Consultant Dermatologist, NHS Fife (Edinburgh resident) Dr Anthony Simon, General Practitioner, Craigmillar Medical Group Dr Chris Smith, Foundation Doctor, Western General Hospital, Edinburgh Dr Nick Spencer, Anaesthetic Trainee, Western General Hospital, Edinburgh Dr Andrew Stanfield, Senior Clinical Research Fellow and Honorary Consultant Psychiatrist, University of Edinburgh Dr Elizabeth Steel, Consultant Anaesthetist, Royal infirmary Edinburgh Professor Jon Stone, Consultant Neurologist, Edinburgh Royal Infirmary and University of Edinburgh Professor Cathie Sudlow, Professor of Neurology and Clinical Epidemiology and Head of the Centre for Medical Informatics, Usher Institute, University of Edinburgh Dr Digby Thomas, General Practitioner to the homeless 2001-2021, Edinburgh Homeless/Access Practice Dr Sarah Thompson, Consultant Anaesthetist, Royal Infirmary of Edinburgh Professor Lindsay Thomson, Professor of Forensic Psychiatry, University of Edinburgh; Medical Director of the State Hospitals Board for Scotland and the Forensic Mental Health Managed Care Network Dr Fionn Toolis, General Practitioner, Wester Hailes Medical Practice, Edinburgh Professor Neil Turner, Professor of Nephrology, University of Edinburgh; Honorary Consultant, Royal Infirmary of Edinburgh Dr Stefan Unger, Consultant Respiratory Paediatrician, Royal Hospital for Children and Young People Dr Helen Usher, Consultant Anaesthetist, Royal Infirmary of Edinburgh Dr Anna te Water Naudé, Acute Medicine Core Trainee, Royal Infirmary of Edinburgh Stephen Walls, Senior Charge Nurse, General Intensive Care, Royal Infirmary of Edinburgh Dr Charles Wallis, Consultant Anaesthetist and Chair of Bicycle Users Group, Western General Hospital Dr Andrew Watson, Associate Medical Director for Psychiatry, NHS Lothian Ms Abby White, Psychiatric Nurse, Edinburgh Mr T.O. White, Consultant Orthopaedic Trauma Surgeon (Clinical Lead for Trauma), Royal Infirmary Edinburgh, and Honorary Lecturer, University of Edinburgh Dr William Whiteley, Reader in Neurology, University of Edinburgh; Honorary Consultant Neurologist, NHS Lothian Dr E.B. Wilson, Emergency Department Consultant, Emergency Department, Royal Infirmary of Edinburgh Dr Hilary Young, General Practitioner, Mackenzie Medical Centre / University of Edinburgh
Post-publication supporters: (added after 6th September 2021):
Dr Anna Gaskell, General Practitioner, Newbattle Medical Practice Dr Andrew Grant, Consultant Anaesthetist, Royal Infirmary of Edinburgh Lydia Howells, Lead Nurse for Quality & Standards, NHS Lothian Dr Catriona McLean, Clinical Director and Consultant Clinical Oncologist – Lower GI Cancer, Edinburgh Cancer Centre Professor Gillian Mead, Chair of Stroke and Elderly Medicine, University of Edinburgh Dr David Noble, Consultant Clinical Oncologist, Edinburgh Cancer Centre Dr Faye Robertson, Oncology Registrar, Edinburgh Cancer Centre Professor Roy Robertson, Chair of Addiction Medicine, University of Edinburgh, and General Practitioner, Edinburgh Louise Starkey, Practice Nurse, Slateford Medical Practice, Edinburgh Dr Lucy Wall, Consultant Medical Oncologist, Edinburgh Cancer Centre
Scottish Ambulance Service Mobile Testing Unit (MTU) teams have delivered more than one million tests in just over a year.
The MTUs have been one of biggest projects ever carried out at the Scottish Ambulance Service (SAS).
There are now 39 MTU teams across the country and more than 1100 people employed by the Scottish Ambulance Service, providing a vital service to Scotland.
The MTUS can be dispatched quickly across the country so people in urban, rural and remote areas have easy access to a coronavirus test. The location of the units, planned by National Services Scotland and local resilience partnerships, changes regularly to reflect demand.
John Alexander, General Manager for the Mobile Testing Units (MTUs), said: “The introduction of MTUs has played an important role in the country’s fight against Covid-19, helping to control the spread of the virus.
“All of our MTU staff have done a fantastic job in providing tests to the people of Scotland over the past year and I’m extremely proud they’ve delivered more than one million tests since last September.”
Cabinet Secretary for Health and Social Care Humza Yousaf said: “Reaching one million tests is a major milestone and recognition of the hard work and dedication of Scottish Ambulance Service. My heartfelt thanks go to SAS staff for what they do every single day to care for, and support people across Scotland.
“Our COVID-19 Mobile Testing Units have played a crucial role in bringing testing resources to the communities who need it most. By identifying and isolating cases, we are breaking chains of transmission within those communities and giving us a better chance of stopping the virus from spreading.”
The Scottish Parliament has approved the use of Coronavirus vaccination certificates to enter some events and higher risk venues.
MSPs voted in favour of the measure, which comes into effect on Friday 1 October, aimed at reducing risk while maximising our ability to keep open certain settings and events where transmission is a higher risk and encouraging uptake of the vaccine.
Coronavirus vaccination certificates will be required to enter events such as nightclubs, music festivals and some football grounds.
Staff at venues affected will be able to download a “verifier app” to a smartphone or device from next week, ahead of the launch, which will allow digital checks on the certification status of those attending.
Guidance will be provided for venues on how to use the app, along with options to integrate it into their own systems as the source code is open.
Health Secretary Humza Yousaf said: “We must do all we can to stem the rise in cases and vaccine certification will form part of a range measures which can help us to do this.
“It will only be used in certain higher risk settings and we hope this will allow businesses to remain open and prevent any further restrictions as we head into autumn and winter.
“We do not want to re-impose any of the restrictions that have been in place for much of this year as we all know how much harm they have caused to businesses, to education and to people’s general well-being. But we must stem the rise in cases.
“We want to ensure that as many people get vaccinated as possible and particularly to increase uptake in the younger age cohort, so anything that helps to incentivise that is helpful.
“I urge anyone over 16 to get vaccinated at their local drop-in clinic or through NHS Inform.
“Public behaviour, including key protective measures like face coverings, physical distancing, hand washing and isolating when necessary, continues to play a vital role in reducing the prevalence of the virus and helping us to emerge from the pandemic.”
The new scheme is not being introduced until all Scottish adults have had the opportunity to receive both doses of the vaccine and two weeks have passed to allow the vaccine take effect. The Scottish Government continues to work with sectors affected to ensure that a workable and proportionate scheme is developed.
Under 18s and adults who are ineligible for vaccination will be exempt.
There are currently no plans to introduce certification for the wider hospitality industry but this will be kept under review over the autumn and winter months.
The Scottish Licensed Trade Association has re-iterated it’s opposition to “Covid passports” for those visiting nightclubs and larger event settings.
SLTA says although the suggestion is that the wider hospitality industry will not be affected, the First Minister has clearly stated on a number of occasions that this is “under review” and therefore Covid passports remain a threat hanging over the whole industry.
The industry body says the Scottish Government has pushed these proposals through without any meaningful consultation with the industry.
SLTA MD Colin Wilkinson said: “The Scottish Government issued a paper on the scheme only this morning, just a few hours ahead of the vote, yet we remain unaware of how it will be implemented.
“Where is the evidence that this action is needed and is proportionate, a word often used by the Deputy First Minister in the debate this afternoon? There has been no assessment of the costs to businesses, nor the impact on the sector.
“The sector has been labelled as being a high risk setting, but the hospitality industry is not the only sector where people congregate.
“There is also the concern that Covid passports could lead to vaccination hesitancy and more entrenched views not to get vaccinated. Experts confirm that vaccination does not stop infection and can give a false sense of confidence.
“We are all aware of the failings of the Test and Protect scheme and yet the Government is proposing another system be put in place.”
“The Deputy First Minister said today: The Government has set out proposals … as part of an approach to protect a very fragile situation that we face in Scotland today of rising infection and hospitality that poses a threat to our National Health Service”
Wilkinson added:- “The Scottish Licensed Trade Association again asks where is that evidence and is concerned on the focus on the hospitality sector as this part of the statement makes no mention of the event sector that this will also impact on or other entertainment venues, just “hospitality”. This only reinforces our concerns that this will be rolled out to the wider hospitality sector.
“We fully support moves to reduce the rate and impact of transmission of coronavirus but these must be proportionate and directed to the sectors or settings responsible for spreading transmission the most.
“The finer details of how this scheme will work should have been discussed with the hospitality industry prior to today’s debate and vote.
“The definition of what constitutes a “nightclub or an analogous venue” must be provided as soon as possible in order to allow premises to put procedures in place for the implementation of the scheme.”
Primary and secondary school pupils will start receiving their flu vaccine tomorrow (Monday) as Scotland’s biggest flu immunisation programme gets underway.
Over four million people will be offered the free flu vaccine this year with secondary school pupils eligible for the first time.
Running until December all primary and secondary school pupils will be offered the vaccine which is given as a painless nasal spray.
Public Health Minister Maree Todd said: “More people than ever are being offered the flu vaccine and we hope to see a large uptake amongst pupils as we aim to keep flu out of schools this year.
“If you’ve not missed the deadline for returning consent forms to your school, I’d urge you to complete and return these now. Last year with the public health measures that were in place, there was lower levels of flu than there has been in previous years so our immunity levels to flu may be lower this year.
“The vaccines are safe and the best way to help protect you, and others, from flu this winter.”
The flu virus changes every year, so you need to get the vaccine every year to stay protected. The flu vaccine cannot give you flu, but it can stop you catching it. The COVID-19 vaccine does not offer any protection from flu, you need to get the separate flu vaccine.
In a small number of cases, the nasal spray may not be suitable, and the vaccine can be given as an injection in the arm instead.
For more information about the flu vaccine, visit www.nhsinfrom.scot/childflu, call 0800 030 8013, or speak to a health or immunisation team, practice nurse, or GP.
While the flu vaccination programme will get underway tomorrow, the decision on Covid vaccinations for 12 – 15 year olds is still to be taken.
Health Ministers of the devolved nations wrote to their respective Chief Medical Officers on Friday to seek further advice.
The joint letter reads:
Dear UK Chief Medical Officers,
We are writing on behalf of the 4 nations of the UK following the recent JCVI discussions on 1 and 2 September regarding the COVID-19 vaccination of children and young people aged 12 to 15.
JCVI has updated its advice on this topic. This advice says that the committee is of the opinion that the health benefits from vaccination are marginally greater than the potential harms. However, that margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children at this time.
The JCVI’s advice goes on to suggest that the government may wish to take further advice, including on educational impacts, from the chief medical officers of the 4 nations, with representation from JCVI in these subsequent discussions.
We agree with the approach suggested by JCVI, and so we are writing to request that you take forward work (drawing on experts as you see fit) to consider the matter from a broader perspective, as suggested by the JCVI.
We will consider the advice from the CMOs of the 4 nations, building on the JCVI’s advice, in making our decision. Given the importance of this issue, we would be grateful if you could provide your advice as soon as possible.
Sajid Javid MP Secretary of State for Health and Social Care, HM Government
Eluned Morgan AS/MS Y Gweinidog Iechyd a Gwasanaethau Cymdeithasol Minister for Health and Social Services, Welsh Government
Humza Yousaf MSP Cabinet Secretary for Health and Social Care, Scottish Government
Robin Swann MLA Minister of Health, Northern Ireland Executive
6,152 new cases of COVID-19 were reported in Scotland yesterday.
Parents and carers of children aged 2-5 are being urged to get their child immunised against flu, particularly as immunity levels may be lower this year.
The letters will include details on where and when the vaccine will be given.
Deputy Chief Medical Officer Nicola Steedman, said: “Flu can be serious, even for healthy children and young people. That’s why we’re immunising all children aged 2 up to secondary school pupils in S6 against flu this year.
“With public health restrictions in place last year, everybody, including young children were not exposed to the flu virus and are likely to have lower immunity to flu than in previous years. I’d urge all parents and carers to take up the offer of getting the free flu vaccine for their child this year and help stop the spread of flu. The vaccine is safe and offers the best protection we have against flu.”
For more information about the flu vaccine, visit www.nhsinfrom.scot/childflu, call 0800 030 8013, or speak to a health or immunisation team, practice nurse, or GP.
If you have to reschedule your appointment, you can find information on doing this in your child’s vaccination letter.
JVCI advises politicians to seek further advice from CMOs
The four Chief Medical Officers will provide further advice on the COVID-19 vaccination of young people aged 12 to 15 with COVID-19 vaccines following the advice of the independent Joint Committee on Vaccination and Immunisation (JCVI).
The independent medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has approved the Pfizer and Moderna vaccines for people aged 12 and over after they met strict standards of safety and effectiveness.
The JCVI has advised that the health benefits from vaccination are marginally greater than the potential known harms. It has advised the government to seek further input from the Chief Medical Officers on the wider impacts.
This includes the impact on schools and young people’s education, which has been disproportionately impacted by the pandemic.
UK health ministers from across the four nations have today written to the Chief Medical Officers to request they begin the process of assessing the broader impact of universal COVID-19 vaccination in this age group.
They will now convene experts and senior leaders in clinical and public health to consider the issue. They will then present their advice to ministers on whether a universal programme should be taken forward.
People aged 12 to 15 who are clinically vulnerable to COVID-19 or who live with adults who are at increased risk of serious illness from the virus are already eligible for a COVID-19 vaccine and are being contacted by the NHS, to be invited to come forward.
The JCVI has advised that this offer should be expanded to include more children aged 12 to 15, for example those with sickle cell disease or type 1 diabetes.
Health and Social Care Secretary Sajid Javid said: “Our COVID-19 vaccines have brought a wide range of benefits to the country, from saving lives and preventing hospitalisations, to helping stop infections and allowing children to return to school.
“I am grateful for the expert advice that I have received from the independent Joint Committee on Vaccination and Immunisation.
“People aged 12 to 15 who are clinically vulnerable to the virus have already been offered a COVID-19 vaccine, and today we’ll be expanding the offer to those with conditions such as sickle cell disease or type 1 diabetes to protect even more vulnerable children.
“Along with Health Ministers across the four nations, I have today written to the Chief Medical Officers to ask that they consider the vaccination of 12 to 15 year olds from a broader perspective, as suggested by the JCVI.
“We will then consider the advice from the Chief Medical Officers, building on the advice from the JCVI, before making a decision shortly.”
Scottish Health Minister Humza Yousaf said: “I want to thank the JCVI for today’s advice regarding vaccination for 12 -15 year olds.
“While the JCVI has agreed that the benefits marginally outweigh the risks they are not yet prepared to recommend universal vaccination of 12-15 year olds, however, they have suggested that Health Ministers may wish to ask their respective CMOs to explore the issue further, taking into consideration broader educational and societal impacts.
“Therefore, I have agreed with the other three UK Health Ministers to write a letter asking the four Chief Medical Officers to consider this latest guidance and explore whether there is additional evidence to suggest it would be beneficial to offer vaccination to all 12 – 15 year olds. We have asked for this further work to be conducted as soon as possible.
“A further update will be issued once these discussions have taken place. In the meantime, we will offer the vaccine to those children and young people currently recommended.
“The recent increase in cases of COVID-19 means it remains crucial that everyone who is offered a vaccination takes up the offer.”
